کنترل دیابت در کودکان نیز همانند بزرگسالان از طریق کنترل قند خون صورت می گیرد.اما مشکلاتی از قبیل اصرار بیش از حد و رفتار سختگیرانه برای کنترل قند یا مواردی از این دست می تواند مشکلاتی را از نظر روانی برای کودکان زیر شش سال ایجاد کند. در این بخش از کتاب روان شناسی در درمان دیابت به این موضوع پرداخته شده است و مشکلات و راه حل های این معضل کاملا بررسی شده اند
Once diagnosed, the basic goals ofdiabetes therapy for children under the
age of6 years are similar to those recommended to all children and
adolescents and include the avoidance ofhigh and low blood glucose
levels and the maintenance ofnormal growth and development. However,
due to the continued development ofthe central nervous system, young
children are particularly vulnerable to the debilitating consequences of
recurrent hypoglycaemia.
There is a growing body ofevidence supporting the negative conse-
quencesÐmild cognitive de®citsÐresulting from overly aggressive attempts
to normalize metabolism in young children. Ack et al.24 reported modest
cognitive de®cits in patients with a younger onset oftype 1 diabetes. Others
also reported brain damage as a result ofsevere hypoglycaemia, particularly
in young children25;26. A series ofstudies by Ryan et al.27 29, using a battery
of neurobehavioural tests, identi®ed signi®cant differences between youths
with diabetes compared with control subjects on measures ofverbal intelli-
gence, visual±motor coordination and critical ¯icker threshold. Additionally,
children diagnosed with diabetes under 5 years ofage manifested signi®cant
cognitive de®cits when evaluated during the adolescent years, probably
resulting from symptomatic or asymptomatic hypoglycaemia occurring
earlier in life, before ®nal maturation of the central nervous system. In
another study by Rovet et al.30, children diagnosed under 4 years ofage
scored lower than other children with diabetes diagnosed later in childhood,
and lower than non-diabetic sibling controls on tests ofvisual±spatial
orientation, but not on verbal ability. Hypoglycaemic seizures were found
to occur in greater frequency in the group of children diagnosed under 4
years ofage compared to those diagnosed at older ages, suggesting that
severe hypoglycaemia may impair later cognitive functioning3